Clinical Laboratory Challenges in Diagnosis of systemic Mycoses
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Abstract
Because of non-specific nature of the clinical and radiological findings in mycoses, diagnosis usually depends upon 3 basic laboratory approaches: mycological, serological, and histopathological. Serological and cultural studies should always complement histopathology in the diagnosis of fungal infections. False-negative results may occur in 50% of certain mycoses, and compromised patients with a systemic mycosis are often immunologically unresponsive. In addition, serological tests are not available for many of the unusual or occasional mycotic pathogens. Culture of fungi is often a slow process, and results may not available for several days or weeks. Moreover, when a mycosis is not suspected, the whole biopsy specimen is often fixed for histopathological examinations, so portions are not available for culture. When this occures, histopathological and immunohistological techniques may be the only means of establishing an aetiological diagnosis. The aetiological significance of a cultural isolate can usually be determined by careful histopathological evaluation. Microscopic demonstration of tissue invasion and host reaction resolves the clinical dialemma of whether a fungal isolate is truly pathogenic, or merely a superficial colonizer, a component of the normal mycobiota, or an environmental contaminant. Microscopic evaluation of the inflammatory reaction and the distribution of fungal elements in a tissue section can also help to determine whether the disease is an invasive form or a purely allergic reaction, it can sometimes be used to assess the efficacy of antifungal therapy in pre- and post-treatment biopsy specimens.
Dr. M. Ghahri
I was born in Nov 1959 in Malayer, Hamedan province, east of Iran.
He has graduated in Medical Laboratory Science, Bsc and DMLS in Shahid Beheshti University of Medical Sciences; and Medical Mycology, Msc and PhD in Tehran University of Medical Sciences, and Tarbiat Modares university respectively. He has interested in clinical mycology and has some research on candida and candidiasis in debilitated, and hospitalized patients.
Dr. Ghahri has managed more than 3 sessions in the past on subjects such as: systemic mycotic infections and candidemia, as well as superficial and cutaneous mycoses.
Email: ghahri14 gmail.com
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